Korean J Gastroenterol.  2013 Jul;62(1):55-58. 10.4166/kjg.2013.62.1.55.

A Case of Isolated Small Intestinal Wall Calcification on Patient with Continuous Ambulatory Peritoneal Dialysis

• Choi JI
• Han DS
• Kim HS
• Lee YH
• Kim HS
• Ahn SE
• Jeon YC
• Yi JH

• KMID: 1711280
• DOI: http://doi.org/10.4166/kjg.2013.62.1.55

Abstract

The metastatic calcification is defined as the deposition of calcium salt in normal tissue with an abnormal serum biochemical environment, such as chronic kidney disease, hyperparathyroidism, and hypercalcemia related with malignancy. Although the metastatic calcification can develop in any organs and tissues, presenting its symptoms and complications are rare. Thus a few cases have been reported. This case shows the metastatic calcification of the small intestine without any peritoneal and mesenteric vascular calcification which was early diagnosed by computed tomography and mesenteric angiography in a patient with abdominal pain, receiving continuous ambulatory peritoneal dialysis due to end stage renal disease. The clinician should early consider the metastatic calcification as differential diagnosis when unidentified calcifications are noted in simple abdominal X-ray such as in the present case, and promptly confirm it by using appropriate diagnostic tests in order to prevent its complications and progression.

Keyword

Calcification, ectopic; Small intestine; Continuous ambulatory peritoneal dialysis

MeSH Terms

Calcinosis/*diagnosis/drug therapy/etiology
Calcitriol/therapeutic use
Calcium/blood
Calcium Carbonate/therapeutic use
Calcium Channel Agonists/therapeutic use
Humans
Intestine, Small/*radiography
Kidney Failure, Chronic/therapy
Male
Mesenteric Artery, Superior/radiography
Middle Aged
Peritoneal Dialysis, Continuous Ambulatory/*adverse effects
Tomography, X-Ray Computed
Calcitriol
Calcium
Calcium Carbonate
Calcium Channel Agonists

Figure

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  Fig. 1. The changes of intact parathyroid hormone (iPTH) level and calcium-phosphorous product (Ca×PO4).

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  Fig. 2. Plain abdominal X-ray showed calcification (arrows) in the left upper quadrant (B) although it had not shown in previous plain X-ray (A).

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  Fig. 3. Abdominal CT scan showed linear calcification along jejunal wall (arrows). Also, aortic calcification was also noted (arrowheads).

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  Fig. 4. Superior mesenteric artery angiography of arterial phase (A) and portal phase (B). There were no abnormal findings on both arteries and veins. Mural calcification on small bowel was noted.

Reference

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